Background and purpose: Collecting duct carcinomas of the kidney are a rare malignant tumor accounting for<1%of renal malignancies. It is associated with aggressive nature and more than 50%of patients have metastatic disease at the time of initial diagnosis. The diagnosis of collecting duct carcinoma is often dififcult and to some extent is one of exclusion. This study aimed to study the clinicopathologic features of collecting duct carcinoma of the kidney. Methods:We retrieved the data of ifve cases of collecting duct carcinomas of the kidney from pathology ifles, and determined the expressions of CK19, CAM5.2, CK7, Vimentin, CD10, P63 and PaX-8 by pathohistological observation and immunohistochemical examination. Results: The most common symptoms were blood urine, bellyache and abdomen mass. The tumor originated from the medulla of the kidney central zone. Histologically, the tumors demonstrated irregular tubular or papillary architecture with the stroma of inflammatory cells and fibrous tissue proliferation. Immunohistochemically, the tumor cells were positive for CK19(5/5), CAM5.2(5/5), PaX-8(5/5), Vimentin(2/5), CK7(1/5), and negative for P63, CD10. Conclusion: The correct diagnosis in collecting duct carcinomas of the kidney is based on characteristic morphological features and immunophenotype labeling.

Objective To preliminarily reveal the neurovascular effect of electroacupuncture and adrenomedullin (ADM) in cerebral ischemia-reperfusion injury.Methods Rat changes after middle cerebral artery ischemia and reperfusion, and the effect of electroacupuncture and ADM on them were investigated using the neurological deficit score, somatosensory evoked potentials and TTC staining technique.Results Electroacupuncture and ADM can significantly improve the neurological deficit score after cerebral ischemia and reperfusion (P<0.05), but there was no significant difference between the two (P>0.05). The P1-N1 and N1-P2 peak values of somatosensory evoked potentials decreased significantly at 30 min after ischemia (P<0.05), recovered somewhat at 60 minutes and decreased significantly again during reperfusion (P<0.05). Electroacupuncture or ADM during reperfusion could significantly improved somatosensory evoked potentials at the end of experiment (P<0.05). Electroacupuncture and ADM could significantly reduce the size of cerebral ischemia-induced infarct (P<0.05), but there was no significant differencebetween the two (P>0.05).Conclusions Electroacupuncture can reduce neurological impairment and improve brain blood supply after cerebral ischemia and reperfusion. That is similar to the neurovascular effect of ADM.

Objective To investigate the clinical efficacy of Yang’s pricking-cupping bloodletting in treating cervical spondylotic radiculopathy and its effect on trapezius tension.Methods Seventy-eight patients with cervical spondylotic radiculopathy were randomly allocated to treatment and control groups, 39 cases each. The treatment group received pricking-cupping bloodletting and the control group, conventional acupuncture plus cupping. The nerve function was scored, the visual analogue scale (VAS) score was recorded and trapezius tension was measured in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results There were statistically significant pre-/post-treatment differences in the nerve function score, the VAS score and trapezius tension in the two groups (P<0.01). There were statistically significant post-treatment differences in the VAS score and trapezius tension between the treatment and control groups (P<0.05). The total efficacy rate was 94.9% in the treatment group and 89.7% in the control group. There was a statistically significant difference in theclinical therapeutic effect between the two groups (P>0.05).Conclusions Yang’s pricking-cupping bloodletting can effectively improve pain symptoms and trapezius tension in patients with cervical spondylotic radiculopathy.

Objective To analyze causes for postoperative coxa vara and anti-rotation nail cutting-out after treatment of brittle femoral intertrochanteric fractures with proximal femoral nails ( PFN ).Methods An retrospective study was done on 227 patients with intertrochanteric fracture treated with PFN from June 2006 to February 2009. The causes for postoperative coxa vara and anti-rotation nail cutting-out were analyzed. Harris score was used to evaluate the functional recovery of the hip joint. Results Of all, 221 patients were followed up for 12-48 months (mean 23 months) and six patients were died from serious internal disease within one year. According to Harris evaluation system, the results were excellent and good in 183 patients, fair in 30 and poor in 14. Postoperative coxa vara and anti-rotation nail cuttingout occurred in 16 patients, eight of whom received reoperation to remove internal fixation and skeletal traction at abducent position and the other eight received prosthetic replacement. Conclusions Treatment of proximal femoral fracture with PFN requires a high precision of reduction and operation. Many factors including lateral cortical bone conditions of tuberosity, postoperative patient's cognitive condition,use of improved Jensen-Evans classification and Singh's classification may affect operation outcome.

As a component of traditional Chinese medical therapies, the therapeutic effects of acupuncture for some nervous system diseases have been proven by a large number of clinical and experimental studies. But, the electrophysiological techniques of the commonly used EEG and evoked potentials are still not sufficient to reveal the functional mechanism of acupuncture therapy. The recording technique of microelectrode array (MEA), a kind of electrophysiological technique originated from the overseas biological electrical signal monitoring technique, can be used to record multiple electrical signals of the nervous cells in vivo or in vitro, and maintain the accuracy and stability of the recorded information at the same time, which greatly enriches the means of electrophysiological study. This technique has been already applied in the basic study and clinical treatment abroad, but it is very seldom used in the study of acupuncture field. In order to guide the application of MEA in the research field of acupuncture science, a general survey about the application of MEA technique in vivo was done, and the present situation and prospects of the application of the technique in acupuncture science was briefly analyzed.

OBJECTIVETo investigate the influence of digit-sucking habit on palatal features in pre-school children by using a laser scanning system.

METHODSForty pre-school children were chosen according to the results of questionnaires, among which 20 with digit-sucking habit(digit-sucking group) and 20 without any oral habits(control group). Impression of the upper jaw was taken from each child. After laser scanning the plaster casts, and three-dimensional reconstruction by the computer, parameters of anterior and posterior palatal length, width and height were measured, ratios of height/width, length/width and width ratio of anterior and posterior palatal were analyzed. The differences of palatal features between two groups were analyzed by t test.

RESULTSThere was statistical significance between digit-sucking group and control group in posterior palatal width, anterior palatal length and anterior palatal height. The ratios of height/width and length/width in both posterior and anterior areas were statistically significant (P < 0.05). Compared to the control group, the results indicated that palatal features were relatively deeper, narrower and more protrusive in digit-sucking group.

CONCLUSIONThe digit-sucking habit may have some deleterious impacts on the palatal features in pre-school children with primary dentition. And it is practical to measure the spacial palatal features by using laser scanning system to some extent.

Objective Explore the reversibility and potential molecular mechanisms of pulmonary hypertension in pa-tients with complete transposition of the great arteries (cTGA) combined with ventricular septal defect (VSD) in comparison with those with simple VSD. Methods Twenty-four patients with pulmonary hypertension (mean pulmonary arterial pressure was greater than 30 mmHg) were enrolled in our study, in which 10 patients suffered from cTGA with VSD, and the rest 14 pa-tients suffered from simple VSD. Lung specimens were taken from the right middle lobe of lung before cardiopulmonary bypass. The extent of pulmonary hypertension was then graded according to the Heath-Edwards classification. ELISA was used to exam-ine the expression of eNOS, iNOS, ET-1, ET-AR, ET-BR, MMP-2, MMP-9 and TIMP in all the specimens. Results No statistically significant differences in age, height, weight, the size of VSD, and the pulmonary artery pressure before operation were found between the groups. The level of hemoglobin, aortic and pulmonary arterial oxygen saturation, and the reduction value of pulmonary arterial pressure after surgery were significantly higher in the cTGA patients than that in the simple VSD pa-tients (P < 0.05). All patients had grade 0 - Ⅱ Heath-Edwards changes in their lung biopsy samples. The expression of eNOS and MMP-2 was significantly lower in the TGA group than that in the simple VSD group [eNOS: (280.13 ± 101.92) ng/mg vs. (488.41±249.6) ng/mg, P<0.05; MMP-2:(31.68±15.36)ng/mg vs. (69.28±49.12)ng/mg, P<0.05]. There were no statistically significant differences between the two groups regarding the expression of iNOS, ET-1, ET-AR, ET-BR,MMP-9 or TIMP. Conclusion The imbalance of the NOS/ET system and the MMP/TIMP system involves in the development of pulmonary hypertension in patients with TGA combined with VCD. In patients with cTGA, the high oxygenation state in pul-monary circulation may decrease the expression of MMP2 and eNOS, and may affect the progress of pulmonary hypertension to a certain extent.

ObjectiveTo investigate the effects of dopamine D1 receptor (D1R) tool drugs and combined acupuncture and medicine on striatal expressions of D1R and dopamine transporters (DAT) in middle cerebral artery occlusion (MCAO)-reperfusion rats.MethodForty-seven male SD rats were randomly grouped, used to make a model and given corresponding interventions. The materials were taken and fixed six hrs later. Striatal D1R and DAT expressions were detectedby an immunohistochemical method in different groups.ResultThe neurological deficit score was significantly higher in the model group than in the blank group. Electroacupuncture treatment decreased the score significantly (P<0.05). D1R expression was significantly down-regulated in the antagonist, electroacupuncture and electroacupuncture plus antagonist groups compared with the model group (P<0.05). There was no statistically significant difference in D1R expression between the model group and the antagonist or electroacupuncture plus antagonist group (P>0.05). DAT expression was significantly down-regulated in the other groups compared with the model group (P<0.05). There was no statistically significant difference in D1R expression between all groups except the model group (P>0.05).ConclusionCerebral ischemia-reperfusion can result in high D1R and DAT expressions in rat striatum on the ischemic side. Electroacupuncture, D1R antagonists and a combination of the two can significantly down-regulate D1R expression and have a protective effect on the brain. The effects of electroacupuncture and D1R antagonists can not be added to each other. D1R signaling pathway may be one of ways by which electroacupuncture produces a protective effecton the brain.

Communication skills are the basic requirement for general practitioners,the continuous improvement of communication skills is the guarantee of the service quality.It is crucial to establish an effective evaluation system in the training of communication skills for general practitioners.This article reviews the current status of evaluation scales of doctor-patient communication skill commonly used in China and other countries to provide reference for the establishment of the communication skill evaluation system for general practitioners which is suitable for China's condition.

Objective:To evaluate the shoulder arthroscopic treatment of avulsion fracture of humeral greater tuberosity with double-row suture bridge.Methods:Retrospectively analyzed were the 13 avulsion fractures of humeral greater tuberosity which had been treated by shoulder arthroscopic double-row suture bridge at Bone and Joint Department, Guangzhou Liwan District Orthopedic Hospital from March, 2018 to March, 2020. There were 6 males and 7 females, with an average ages of 52.3 years (from 35 to 69 years). According to the Mutch classification, all the fractures of humeral greater tuberosity were attributed to the avulsion type. Of them, 3 were simple avulsion fractures of humeral greater tuberosity and 10 were complicated with shoulder anterior dislocation which was reduced manually before operation. There were 3 obsolete avulsion fractures of humeral greater tuberosity. Regular clinic and X-ray follow-ups were carried out. At the final follow-up, the pain, range of motion (ROM) and stability of the shoulder joint were assessed using visual analogue scale (VAS), American shoulder elbow scores (ASES), and Korean shoulder scores (KSS).Results:All the patients were followed up for an average of 12.3 months (from 10 to 16 months) postoperatively. No infection or shoulder instability was observed. At the final follow-up, the abduction and elevation averaged 164.6° (from 135° to 180°), the lateral external rotation 62.7° (from 40° to 80°), the internal rotation touch back test T10 level (from L2 to T6), the VAS 0.65 (from 0 to 2.5), the ASES 90.5 (from 78 to 100), and the KSS 91.5 (from 84 to 100).Conclusion:Shoulder arthroscopic treatment of avulsion fracture of humeral greater tuberosity with double-row suture bridge is minimally invasive and allows for repair of combined injury, leading to quick postoperative recovery.